Clinical History

This 70 year-old Caucasian man was admitted to the hospital on November 14, 1991 because of a lesion of the large bowel with partial obstruction. He had a diagnosis of chronic lymphocytic leukemia many years ago treated with chemotherapy. Apparently he showed also bilateral pyelonephrosis and metastatic disease to iliac lymph nodes. The prostate was thought to be benign. His primary problem was in the upper urinary tract. X-ray examination of the colon showed diverticulosis. No definite nodes or masses. No gallstones. The esophagus was normal. The distal stomach showed mucosal thickening and deformity with a certain amount of fixation and rigidity probably due to prepyloric ulcer with ulceration raised on x-ray examination of the upper G.I. tract. X-ray examination of urinary tract showed Stage II-III hydronephrotic changes in both kidneys. The bladder was poorly defined. The ureters were not seen. The findings were consistent with an obstruction process in the lower urinary tract.